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The association between sodium intake and coronary and carotid atherosclerosis in the general Swedish population

Wuopio, Jonas ; Ling, Yi Ting ; Orho-Melander, Marju LU ; Engström, Gunnar LU and Äarnlöv, Johan (2023) In European Heart Journal Open 3(2).
Abstract

Aims: A high intake of salt raises blood pressure and the risk of cardiovascular disease. Previous studies have reported on the association between salt intake and carotid stenosis, but the association with coronary atherosclerosis has not been reported. Therefore, this project aimed at studying the association between salt intake and both carotid and coronary atherosclerosis in a contemporary community-based cohort. Methods and results: Estimated 24-h sodium excretion (est24hNa) was calculated by the Kawasaki formula for participants of two sites (Uppsala and Malmö) of the Swedish Cardiopulmonary bioImage Study, who underwent a coronary computed tomography (n = 9623) and measurement of coronary artery calcium score (CACS, n = 10 289).... (More)

Aims: A high intake of salt raises blood pressure and the risk of cardiovascular disease. Previous studies have reported on the association between salt intake and carotid stenosis, but the association with coronary atherosclerosis has not been reported. Therefore, this project aimed at studying the association between salt intake and both carotid and coronary atherosclerosis in a contemporary community-based cohort. Methods and results: Estimated 24-h sodium excretion (est24hNa) was calculated by the Kawasaki formula for participants of two sites (Uppsala and Malmö) of the Swedish Cardiopulmonary bioImage Study, who underwent a coronary computed tomography (n = 9623) and measurement of coronary artery calcium score (CACS, n = 10 289). Carotid ultrasound was used to detect carotid plaques (n = 10 700). Ordered logistic regression was used to calculate odds ratios (OR) per 1000mg increase in est24hNa. We also investigated potential J-formed associations using quintiles of est24hNa. Increased est24hNa was associated with increased occurrence of carotid plaques [OR: 1.09, P < 0.001, confidence interval (CI): 1.06-1.12], higher CACS (OR: 1.16, P < 0.001, CI: 1.12-1.19), and coronary artery stenosis (OR: 1.17, P < 0.001, CI: 1.13-1.20) in minimal adjusted models. Associations were abolished when adjusting for blood pressure. When adjusting for established cardiovascular risk factors (not including blood pressure), associations remained for carotid plaques but not for coronary atherosclerosis. There was no evidence of J-formed associations. Conclusion: Higher est24hNa was associated with both coronary and carotid atherosclerosis in minimal adjusted models. The association seemed mainly mediated by blood pressure but to some degree also influenced by other established cardiovascular risk factors.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atherosclerosis, Cardiovascular disease, Hypertension, Salt, Sodium
in
European Heart Journal Open
volume
3
issue
2
article number
oead024
publisher
Oxford University Press
external identifiers
  • scopus:85159714649
ISSN
2752-4191
DOI
10.1093/ehjopen/oead024
language
English
LU publication?
yes
id
5ef4ed27-d5dd-4da4-ba19-80a6911677e2
date added to LUP
2023-08-22 15:09:37
date last changed
2024-02-19 23:14:41
@article{5ef4ed27-d5dd-4da4-ba19-80a6911677e2,
  abstract     = {{<p>Aims: A high intake of salt raises blood pressure and the risk of cardiovascular disease. Previous studies have reported on the association between salt intake and carotid stenosis, but the association with coronary atherosclerosis has not been reported. Therefore, this project aimed at studying the association between salt intake and both carotid and coronary atherosclerosis in a contemporary community-based cohort. Methods and results: Estimated 24-h sodium excretion (est24hNa) was calculated by the Kawasaki formula for participants of two sites (Uppsala and Malmö) of the Swedish Cardiopulmonary bioImage Study, who underwent a coronary computed tomography (n = 9623) and measurement of coronary artery calcium score (CACS, n = 10 289). Carotid ultrasound was used to detect carotid plaques (n = 10 700). Ordered logistic regression was used to calculate odds ratios (OR) per 1000mg increase in est24hNa. We also investigated potential J-formed associations using quintiles of est24hNa. Increased est24hNa was associated with increased occurrence of carotid plaques [OR: 1.09, P &lt; 0.001, confidence interval (CI): 1.06-1.12], higher CACS (OR: 1.16, P &lt; 0.001, CI: 1.12-1.19), and coronary artery stenosis (OR: 1.17, P &lt; 0.001, CI: 1.13-1.20) in minimal adjusted models. Associations were abolished when adjusting for blood pressure. When adjusting for established cardiovascular risk factors (not including blood pressure), associations remained for carotid plaques but not for coronary atherosclerosis. There was no evidence of J-formed associations. Conclusion: Higher est24hNa was associated with both coronary and carotid atherosclerosis in minimal adjusted models. The association seemed mainly mediated by blood pressure but to some degree also influenced by other established cardiovascular risk factors.</p>}},
  author       = {{Wuopio, Jonas and Ling, Yi Ting and Orho-Melander, Marju and Engström, Gunnar and Äarnlöv, Johan}},
  issn         = {{2752-4191}},
  keywords     = {{Atherosclerosis; Cardiovascular disease; Hypertension; Salt; Sodium}},
  language     = {{eng}},
  number       = {{2}},
  publisher    = {{Oxford University Press}},
  series       = {{European Heart Journal Open}},
  title        = {{The association between sodium intake and coronary and carotid atherosclerosis in the general Swedish population}},
  url          = {{http://dx.doi.org/10.1093/ehjopen/oead024}},
  doi          = {{10.1093/ehjopen/oead024}},
  volume       = {{3}},
  year         = {{2023}},
}